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Contact Information

BLACKDUCK DENTAL CLINIC
49 SUMMIT AVE. SE
BLACKDUCK, MN56630
 Phone: 218-835-4227
 Fax: 218-835-7512
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for BLACKDUCK DENTAL CLINIC

NPI Number 1003991944
LBN Legal business name BLACKDUCK DENTAL CLINIC
Authorized official PAUL BENGTSON - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2006
Last updated 07/21/2022 - About 4 years ago
Identifiers
MN License # 7789
MN Other 81202BE BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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